Department of Cardiology, Mitsubishi Kyoto Hospital, 1 Katsura Gosho-cho, Nishikyo-ku, Kyoto, 615-8087, Japan.
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Interv Card Electrophysiol. 2022 Nov;65(2):461-470. doi: 10.1007/s10840-022-01254-5. Epub 2022 May 21.
The characteristics of atrial fibrillation (AF) drivers identified by CARTOFINDER have not been thoroughly evaluated. Therefore, the current study was sought to validate the reliability of AF drivers.
The reliability of focal and rotational activation identified by CARTOFINDER during AF was assessed by the sequential recordings in each site before and after pulmonary vein isolation (PVI) in 27 persistent AF patients. The primary outcome measures were the reproducibility rate during the sequential recordings and the stability rate between pre- and post-PVI.
Among 32,135 points in 509 sites, focal activation was identified in 1775 points (5.5%) with a repetition of 11 (6-26) times during the recording. Rotational activation was identified in 132 points (0.4%) with a repetition number of 21 (14-21) times. AF drivers had significantly higher voltage and shorter AF cycle length than non-AF driver sites. The reproducibility rate of focal activation during the sequential recordings was 57.8% and increased with the repetition number. The reproducibility rate of rotational activation was 37.4%. The prevalence and the reproducibility rate of focal activation in post-PVI were significantly lower than pre-PVI (5.3% versus 6.0%, P = 0.02; 53.4% versus 63.6%, P < 0.001). The stability rate of focal activation between pre- and post-PVI was only 28.3% but increased with the repetition number. There was no stable rotational activation between pre- and post-PVI.
The reproducibility of AF drivers, especially focal activation, identified by CARTOFINDER is relatively favorable, but the stability between pre- and post-PVI was poor. These results depended on the repetition number during the recording.
CARTOFINDER 识别的心房颤动（AF）驱动灶的特征尚未得到充分评估。因此，本研究旨在验证 AF 驱动灶的可靠性。
在 27 例持续性 AF 患者中，在肺静脉隔离（PVI）前后分别在每个部位进行连续记录，评估 CARTOFINDER 识别的局灶和旋转激活的可靠性。主要观察指标为连续记录的可重复性率和 PVI 前后的稳定性率。
在 509 个部位的 32135 个点中，1775 个点（5.5%）识别出局灶激活，记录过程中重复 11（6-26）次。132 个点（0.4%）识别出旋转激活，重复次数为 21（14-21）次。AF 驱动灶的电压明显较高，AF 周期长度明显较短。连续记录时局灶激活的可重复性率为 57.8%，并随重复次数增加而增加。旋转激活的可重复性率为 37.4%。PVI 后局灶激活的发生率和可重复性率显著低于 PVI 前（5.3%比 6.0%，P=0.02；53.4%比 63.6%，P<0.001）。PVI 前后局灶激活的稳定性率仅为 28.3%，但随重复次数增加而增加。PVI 前后无稳定的旋转激活。
CARTOFINDER 识别的 AF 驱动灶，尤其是局灶激活的可重复性相对较好，但 PVI 前后的稳定性较差。这些结果取决于记录过程中的重复次数。
